Concierge oncology · United Kingdom
Intraoperative radiotherapy in the UK, without the sales pitch.
A single dose of radiation delivered to the tumour bed during surgery — IntraBeam for breast, mobile electron IORT for rectal and sarcoma. Offered at a handful of UK centres, and not always the smart choice. We give you the honest picture.
Why patients choose us
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A commissioned IORT centre, not a promise
IORT lives in a handful of UK theatres. We introduce you to the ones that actually do it — Christie, Marsden, University College London, and a small private list.
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The honest conversation about 5-fraction WBI
For most early breast cancers, the FAST-Forward 5-fraction whole-breast course is now the UK default. If that fits you better than IORT, we say so.
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Independent, and free
We are paid by no clinic and no manufacturer, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private IORT costs in the UK.
Indicative ranges across the small UK network of IORT-capable centres. Send the details and we quote firm figures across the sensible options.
In short
Breast lumpectomy with IntraBeam IORT in our network: £12,000–£22,000, one visit to theatre.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Breast IORT (IntraBeam) with lumpectomy — private | £12,000–£22,000 | Half-day theatre | Same admission |
| IORT boost (additional to lumpectomy) — private | £6,000–£12,000 | +30–45 min added to case | Same admission |
| Rectal / pelvic electron IORT — specialist centre | £15,000–£30,000 | Part of major resection | Inpatient |
| Sarcoma IORT boost — specialist centre | £12,000–£25,000 | Part of major resection | Inpatient |
| Joint surgical + oncology consultation | £350–£650 | 45 min | Same visit |
| Second opinion on IORT eligibility | £300–£550 | 30–45 min | 1–3 working days |
Prices vary by centre, by modality (IntraBeam, mobile electron, HDR brachytherapy), by whether the IORT is a stand-alone treatment or a boost, and by the underlying surgery. NHS access is via specific commissioned centres. We confirm a firm quote within one working day.
The problem
The right centre, the right modality, the right honest comparison.
IORT is a niche modality with strong marketing. It is genuinely useful in a small set of situations and oversold in a much larger one. We separate the two before you commit.
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Told IORT is the newest thing?
Newer is not always better. FAST-Forward 5-fraction WBI is more recent than TARGIT and is now the UK default for early breast cancer.
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Only one centre offered?
A handful of UK centres run IORT programmes. We introduce you to the ones with the volume and outcome data that support your case.
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Want the honest downside?
Small increase in late local recurrence for breast IORT. Neuropathy risk for pelvic IORT. Named, not buried in the consent form.
The journey
From enquiry to recovery — what happens, in order.
One case manager from first message to review — including the pathology decision on whether further external beam radiotherapy is needed.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
One admission for surgery and IORT
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Diagnosis, staging, planned surgery, and whether IORT has been raised.
- 02
Before
We come back with a recommendation
Within one working day: whether IORT is appropriate for your case, which centre, and how it compares to 5-fraction WBI or standard EBRT.
- 03
Before
We arrange the joint clinic
A single appointment with the surgeon and the clinical oncologist so the IORT decision is made together, not in sequence.
- 04
On the day
Arrival at the theatre
General anaesthetic, standard surgical prep. The IORT team joins theatre once the tumour is out and the cavity is ready.
- 05
On the day
The dose itself
15 to 30 minutes with the applicator in the cavity. Theatre is cleared or shielded during delivery — IntraBeam is self-shielded, electron IORT needs the room cleared.
- 06
On the day
Surgical closure and recovery
The applicator comes out, closure is completed, and you recover as after any lumpectomy or resection. Home the same day or after one night.
- 07
After
Review and any further radiotherapy
Pathology decides whether IORT stands alone or is topped up with EBRT. We stay in the loop until that decision is made.
Typical end-to-end: 2–4 weeks from enquiry to theatre. Pathology decision on top-up EBRT: 2–3 weeks after surgery.
When it helps
When IORT is genuinely worth considering.
The UK situations where IORT actually earns its place — and the situation where a shorter external beam course is the smarter answer.
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Early-stage breast cancer
pT1–2, N0–1, age over 45, low-grade, ER-positive, no LVI, no EIC, no multifocal disease — the TARGIT-A eligibility bracket.
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Rectal cancer with tight or R1 margin
After total mesorectal excision for T3–T4 or margin-positive disease — electron IORT as a boost at Christie or the Marsden.
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Recurrent pelvic malignancy
Salvage or palliative electron IORT for recurrent rectal or gynaecological disease when re-irradiation options are limited.
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Retroperitoneal or extremity sarcoma
Post-resection boost to the tumour bed when margins are close or positive, to improve local control.
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Gynaecological cancer
Endometrial, cervical, vulval or para-aortic disease — usually in the re-irradiation setting at a specialist centre.
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Pancreatic cancer (rare UK)
Occasionally offered post-Whipple in selected centres. Evidence base is thinner than for breast or rectal disease.
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Paediatric solid tumours (rare)
Very selective use — abdominal or pelvic paediatric tumours in specialist tertiary centres.
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When 5-fraction WBI is a better fit
For many early breast cancers the FAST-Forward 5-fraction whole-breast course is now the UK default. IORT is not always the smart choice.
IORT modalities
IORT is not one thing.
The three UK modalities and the two most important alternatives — what each one actually involves, and where it fits.
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Zeiss INTRABEAM (50 kV X-ray)
Spherical applicator inserted into the lumpectomy cavity. Self-shielded — theatre staff can remain nearby. The TARGIT-A protocol for breast IORT.
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Mobile electron IORT (Mobetron)
Mobile linear accelerator delivering an electron beam via a cone into the surgical bed. Used for rectal, gynae and sarcoma boosts.
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Mobile electron IORT (Novac, LIAC)
European mobile electron platforms used in a small number of UK centres for the same GI, gynae and sarcoma indications.
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HDR brachytherapy IORT
High-dose-rate iridium-192 delivered through applicators sited in the surgical bed. Highly specialist — used for complex re-irradiation.
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IORT as sole radiotherapy
A single 20 Gy dose replaces the 3–5 week external beam course in carefully selected TARGIT-eligible breast patients.
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IORT as a boost
A single intraoperative dose to the tumour bed, followed by a standard external beam course to the wider volume.
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5-fraction WBI (FAST-Forward) — alt
Not IORT, but the NICE-endorsed 26 Gy in 5 fractions whole-breast course is now the UK default for most early breast cancers. We compare fairly.
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Standard EBRT — alternative
Conventional 3-week whole-breast or pelvic external beam radiotherapy remains standard for many patients. IORT is niche, not default.
Our vetted UK network
A small panel of IORT centres, we picked them.
Commissioned NHS centres and their private partners — a short list that includes the Christie, the Royal Marsden, University College London Hospitals, and selected London private centres. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every IORT centre in our network.
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A commissioned UK IORT centre with an active programme, not a pilot
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Consultant clinical oncologist and consultant surgeon working as one team
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A joint clinic appointment before the operating date, not sequential letters
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Honest comparison with 5-fraction FAST-Forward WBI and standard EBRT
Safety and outcomes
What to expect afterwards — honestly.
IORT is safe in the hands of an experienced team, but it is not risk-free and it is not automatically the best option. The honest picture below.
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A single dose, delivered in theatre
Typically 20 Gy in 15–30 minutes into the tumour bed, immediately after resection, while you are still under general anaesthetic.
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Theatre time extends by 15–45 minutes
Positioning, applicator selection and dose delivery add to the case length. The total anaesthetic is longer than a lumpectomy alone.
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Radiation safety in the room
IntraBeam is self-shielded — staff can remain nearby. Electron IORT requires the theatre to be cleared during the dose. You are asleep either way.
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Breast IORT: seroma and fat necrosis
Seroma is reported in 20–30% and fat necrosis in up to 20% of breast IORT cases. Most settle; a few need drainage or a further procedure.
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Breast IORT: skin and mammogram effects
Occasional skin telangiectasia and changes on later mammographic surveillance that a specialist breast radiologist should read.
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Pelvic IORT: neuropathy is the limit
Sacral or lumbosacral nerve neuropathy is the dose-limiting toxicity of rectal IORT. Ureteric injury and pelvic pain are also recognised.
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Local recurrence: honest 10-year picture
TARGIT-A showed non-inferiority at 5 years for low-risk patients, with a small increase in late local recurrence at 10 years. Worth knowing before you choose.
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The alternative is usually 5-fraction WBI
FAST-Forward is one week of external beam radiotherapy, no operating-room capital cost, and now NICE-endorsed. IORT is not automatically better.
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Red flags after any radiotherapy
Rapidly increasing pain, spreading redness, fever, bleeding or a new lump warrants same-day contact with your clinical oncology team.
Reading your treatment summary
Your IORT summary in four parts. Read the last one first.
Whichever modality was used, the summary the clinical oncologist sends you keeps to the same shape.
A quiet reminder
Radiotherapy language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the summary before your review, just ask.
- 01 Header
Diagnosis, staging and eligibility
Why IORT was considered — tumour type, size, grade, receptor status, nodal status — and whether you met the TARGIT-A or centre-specific criteria.
- 02 Technique
Modality, dose and applicator
Which device was used (IntraBeam, Mobetron, brachytherapy), the dose delivered, applicator size and the volume treated.
- 03 Findings
Pathology and margins
Final pathology on the resected specimen — margins, LVI, receptor status — and whether these change the plan.
- 04 Impression
Sole treatment or top-up EBRT
Read this first: whether the IORT stands alone, or whether standard external beam radiotherapy is now recommended on top, and when.
Recognised by major UK insurers
Cover for IORT varies by insurer, by indication and by centre — most major UK insurers will fund IORT when it is the recommended treatment for an eligible cancer. We confirm cover before booking.
Frequently asked
Everything we get asked about IORT.
Quick answers on which UK centres offer it, how it compares to 5-fraction WBI, and what the side effects really look like.
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What is intraoperative radiotherapy (IORT)?
IORT is a single, high-dose treatment of radiation delivered directly to the tumour bed during surgery — while you are still under general anaesthetic and immediately after the tumour has been removed. Typical dose is around 20 Gy in 15 to 30 minutes.
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Is IORT available on the NHS in the UK?
Yes, but only through a small number of specifically commissioned centres. Breast IORT with the Zeiss IntraBeam is supported by NICE guidance IPG501 (2014). Electron IORT for rectal and sarcoma work is offered at centres such as the Christie and the Royal Marsden.
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Which UK centres offer IORT?
Breast IORT with IntraBeam and electron IORT for pelvic and sarcoma cases are concentrated at a handful of centres including the Christie in Manchester, the Royal Marsden, University College London Hospitals, and a small private list. We introduce you to the ones that fit your case.
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How much does private IORT cost in the UK?
A breast lumpectomy with IntraBeam IORT is typically £12,000–£22,000 privately, on top of the standard surgical fee. Pelvic or sarcoma electron IORT sits at £15,000–£30,000 as part of a major resection. We confirm firm figures before you commit.
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Is IORT better than 5-fraction whole-breast radiotherapy?
Not automatically. The FAST-Forward 26 Gy in 5 fractions whole-breast course is NICE-endorsed and increasingly the UK default for early breast cancer. IORT avoids the 3-week external beam course but carries a small increase in late local recurrence at 10 years. It is a real choice, not a clear win.
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What are the side effects of breast IORT?
Seroma occurs in 20–30% and fat necrosis in up to 20% of breast IORT cases. Wound infection, occasional skin telangiectasia and changes on later mammographic surveillance are also reported. Most patients settle without further intervention.
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What are the side effects of pelvic or sarcoma IORT?
The dose-limiting problem is neuropathy — usually sacral or lumbosacral nerve — after rectal or pelvic IORT. Ureteric injury and chronic pelvic pain are also recognised. Toxicity is weighed against the benefit of improved local control for T4 or margin-positive disease.
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Does IORT replace external beam radiotherapy?
For carefully selected TARGIT-eligible breast patients, a single 20 Gy dose can replace the whole-breast external beam course. In most other settings — pelvic, sarcoma, gynae — IORT is used as a boost in addition to standard external beam radiotherapy, not instead of it.
Related treatments
Looking for something else?
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Intensity-modulated radiation therapy (IMRT)
Precisely shaped external beam radiotherapy for complex tumour volumes.
Learn more -
Image-guided radiation therapy (IGRT)
Imaging-verified positioning to keep external beam radiotherapy on target.
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All tests and procedures
Every test, procedure and treatment we arrange.
Learn more